Provider Demographics
NPI:1154366805
Name:TAYLOR, TANISHA KADENE (MD)
Entity type:Individual
Prefix:DR
First Name:TANISHA
Middle Name:KADENE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:832 BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-3829
Mailing Address - Country:US
Mailing Address - Phone:609-695-7471
Mailing Address - Fax:609-393-5272
Practice Address - Street 1:832 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-3829
Practice Address - Country:US
Practice Address - Phone:609-695-7471
Practice Address - Fax:609-393-5272
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042698207R00000X
NJ5MA081130002083X0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine